by Alexei Korolyov, Special for USA TODAY

by Alexei Korolyov, Special for USA TODAY

MOSCOW - President Vladimir Putin likes to claim he has the nation back on its feet, but it's joked that it's often on its back or slumped over a bar, a fact confirmed by the latest findings on Russian drinking

Russia has always had a deeply entrenched tradition of heavy drinking, but a new study in The Lancet shows that the problem has worsened in recent years despite attempts to curb the cultural custom. And Russian men are dying prematurely because of it.

The British-based medical journal reported recently that 25% of Russian men die before the age of 55, most due to excessive alcohol and tobacco consumption. The proportion was even higher â?? at 37% â?? before the introduction of stricter alcohol policies in 2006.

The comparable figure for Britain in 2005 was 7%.

The study, conducted by researchers from the Russian Cancer Center in Moscow, Oxford University in Britain and the World Health Organization International Agency for Research on Cancer in France, asked 151,000 people in three Russian cities how much vodka they drank and followed them for up to a decade. In this period, 8,000 died.

It also drew on a previous survey in which families of 49,000 people who had died were asked about the drinking patterns of the deceased.

"Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka," said study co-author Richard Peto of the University of Oxford.

The findings have prompted health officials and church groups to do more to address the problem.

Russian Orthodox priests held a "procession of abstainers" in the country's second-biggest city, St. Petersburg, last week in an effort to encourage Russians to quit drinking.

"Let's not relax and look for enemies around us," said Sergei Uchaneishvili in news portal Pravoslavie.ru. "The enemies are inside us."

Some say the Kremlin appears to lack a clear strategy to break Russia's dependence on vodka. A zero-tolerance policy on drunken driving implemented by Russia's previous president, Dmitry Medvedev, was overturned by Vladimir Putin in September.

"It was sheer chaos, people just couldn't get enough," recalls Andrei Konstantinovich, co-owner of a German-style drinking hall in downtown Moscow, speaking above the din of drinkers.

When people could not buy vodka, they turned to window-cleaning fluids and antifreeze instead, he says.

"But some of us survived, and well, you see, I just couldn't wean myself off it," he joked.

Much has changed since the 1990s, and the sight of men getting drunk on whatever was available is rare. Even the revelry of Paratroopers' Day, when former paratroopers swarm Moscow and swim in fountains, is passing into history.

Even so, Russia makes it easy to be a drinker, some say.

Vodka can sell for as little as 100 rubles, or the equivalent of $3. Lax implementation of licensing hours and sales rules make drinking an ineradicable and all-night part of Russian life, as much as bribery and corruption, locals say.

The result is that Russians on average consume more than 14 quarts of pure alcohol a year per person, according to the country's chief medical officer, Yevgeny Bryun.

And though his fellow countrymen cut their alcohol intake in 2013 compared with previous years, they still "drank wrongly," Bryun said recently. "We drink strong spirits in one gulp and eat unsuitable food."

These habits produce deaths from alcohol poisoning, accidents, violence and several categories of disease, according to the Lancet study.

However, the per capita alcohol consumption alone cannot explain Russia's high male mortality rate, said JÃ¼rgen Rehm from the Centre for Addiction and Mental Health in Canada, commenting on the study.

"It is the combination of high overall volume with the specific pattern of episodic binges that is necessary to explain the high level and fluctuating trends of total and alcohol-attributed mortality in Russia," he said, echoing many Russian sociologists who argue that it is culture and attitudes toward drink that are at the core of the problem.

"Since the average life expectancy from birth for men in Russia is still only 64 years, ranking among the lowest 50 countries in the world, more effective alcohol and tobacco policy measures are urgently needed."